| NPI | 1902893860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 316640) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME 016608) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2025-01-08 |